Wu T T, Lee Y H, Huang J K
Division of Urology, Department of Surgery, Kaohsiung Veterans General Hospital, 386, Ta-Chung 1st Road, Kaohsiung 813, Taiwan.
Zhonghua Yi Xue Za Zhi (Taipei). 2001 Jan;64(1):9-14.
The purpose of our study was to examine the frequency of p53 mutation and bcl-2 expression in transitional cell carcinoma of the urinary bladder and their clinicopathologic correlates.
A total of 137 patients who underwent transurethral resection for primary transitional cell bladder carcinomas were enrolled. The paraffin-embedded tissue blocks were recut and stained by monoclonal anti-p53 (DO7) and anti-bcl-2 (124) antibodies. The bcl-2 and p53 immunoreactivity was correlated to tumor grade and pathological stage.
p53 mutation was identified in 102 patients (78.5%). The mutation was most common in grade 3 tumors (95%) as compared to grade 2 (74%) and grade 1 (80%) tumors, but the difference was not statistically significant (p = 0.289). Stage pT2 tumors had higher incidence of p53 mutation (97%) as compared to pTa-1 tumors (71%, p = 0.0003). Only 17 tumors (13%) expressed bcl-2; the grade 3 tumors had significantly higher incidence of bcl-2 expression (p = 0.04). The bcl-2 expression was not related to pathological stage (p = 0.083). There was no interrelation between p53 mutation and bcl-2 expression (p = 0.97). Grade 3 tumors correlated well with invasive disease (p < 0.00001). When grade 2 tumors were evaluated separately, p53 mutation was positively correlated with disease invasion (p = 0.001).
Grade 3 tumor was the most important variable associated with tumor invasion in transitional cell carcinoma of the urinary bladder. p53 mutation was positively correlated with invasive disease. Grade 2 tumors with p53 mutation had greater probability of disease invasion. Expression of bcl-2 positively correlated with tumor grade but not pathological stage.
我们研究的目的是检测膀胱移行细胞癌中p53突变和bcl-2表达的频率及其临床病理相关性。
共有137例因原发性膀胱移行细胞癌接受经尿道切除术的患者入组。将石蜡包埋组织块重新切片，并用抗p53单克隆抗体（DO7）和抗bcl-2单克隆抗体（124）染色。bcl-2和p53免疫反应性与肿瘤分级和病理分期相关。
102例患者（78.5%）检测到p53突变。与2级肿瘤（74%）和1级肿瘤（80%）相比，3级肿瘤中该突变最为常见（95%），但差异无统计学意义（p = 0.289）。与pTa-1期肿瘤（71%，p = 0.0003）相比，pT2期肿瘤p53突变发生率更高（97%）。仅17例肿瘤（13%）表达bcl-2；3级肿瘤bcl-2表达发生率显著更高（p = 0.04）。bcl-2表达与病理分期无关（p = 0.083）。p53突变与bcl-2表达之间无相关性（p = 0.97）。3级肿瘤与浸润性疾病密切相关（p < 0.00001）。单独评估2级肿瘤时，p53突变与疾病浸润呈正相关（p = 0.001）。
3级肿瘤是膀胱移行细胞癌中与肿瘤浸润相关的最重要变量。p53突变与浸润性疾病呈正相关。有p53突变的2级肿瘤发生疾病浸润的可能性更大。bcl-2表达与肿瘤分级呈正相关，但与病理分期无关。
